SAT-TB、Xpert MTB/RIF检测在肺结核诊断中的应用

Application of SAT-TB and Xpert MTB/RIF detection in the diagnosis of pulmonary tuberculosis

目的 探讨RNA恒温扩增实时检测技术(SAT-TB)、结核分枝杆菌及利福平耐药实时荧光定量核酸扩增(Xpert MTB/RIF)在肺结核诊断中的应用价值。方法 选取2017年2月-2019年3月在淮安第一医院就诊的疑似肺结核患者201例,根据行业标准WS 288-2017《肺结核诊断》诊断,均接受SAT-TB、Xpert MTB/RIF检查。结果 201例疑似肺结核患者中,最终经临床确诊150例、非肺结核51例。SAT-TB与临床诊断一致的有158例,一致性Kappa=0.453,一致性好;Xpert MTB/RIF与临床诊断一致的有140例,一致性Kappa=0.222,一致性差;SAT-TB和Xpert MTB/RIF联合检查诊断肺结核的灵敏性和阴性预测值分别为93.33%和74.36%,高于Xpert MTB/RIF(79.33%和41.51%)(P <0.05),灵敏性也明显高于SAT-TB(84.00%)(P <0.05)。结论 SAT-TB联合Xpert MTB/RIF在肺结核诊断中有较好的应用价值,值得临床使用。

Objective To explore the value of SAT-TB and Xpert MTB/RIF in the diagnosis of pulmonary tuberculosis.Methods A total of 201 suspected pulmonary tuberculosis cases treated in Huai'an First Hospital from February 2017 to March 2019 were selected as the subjects,diagnosed according to WS 288-2017 Standard titled as"Diagnosis of Tuberculosis".All of the cases were examined by SAT-TB and Xpert MTB/RIF.Results Among the 201 suspected pulmonary tuberculosis cases,150 cases pulmonary tuberculosis and 51 cases non-pulmonary tuberculosis were finally diagnosed clinically.The consistency between SAT-TB and clinical diagnosis was 158 cases,Kappa=0.453.The consistency between Xpert MTB/RIF and clinical diagnosis was 140 case,Kappa=0.222,the consistency was poor.The sensitivity and negative predictive value of combined detection was 93.33%and 74.36%,which was higher than that of Xpert MTB/RIF(79.33%,41.51%)(P<0.05),and was significantly higher than that of SAT-TB(84.00%)(P<0.05).Conclusion SAT-TB combined with Xpert MTB/RIF detection showed a application value in the diagnosis of tuberculosis,and was worthy for clinical use.